Idiopathic pleuroparenchymal fibroelastosis (PPFE) is a rare, recently classified entity that consists of pleural and subjacent parenchymal fibrosis predominantly in the upper lungs. In an official American Thoracic Society/European Respiratory Society statement in 2013, this disease is introduced as a group of rare idiopathic interstitial pneumonias. We describe a case of a 76-year-old woman with cough and recurrent pneumothorax. She was admitted to our hospital with severe cough at first. High resolution computed tomography (HRCT) disclosed multifocal subpleural consolidations with reticular opacities in both lungs, primarily in the upper lobes, suggesting interstitial pneumonia. Rheumatoid lung was diagnosed initially through an elevated rheumatoid factor, HRCT and surgical biopsy at the right lower lobe. However, one month later, pneumothorax recurred. Surgical biopsy was performed at the right upper lobe at this time. The specimens revealed typical subpleural fibroelastosis. We report this as a first case of idiopathic PPFE in Korea after reviewing the symptoms, imaging and pathologic findings.
Choroidal metastasis from colorectal cancer is very rare and has not been reported before in Korea. We report a case of eye hyperemia and discomfort in a patient with advanced colon cancer. Orbit magnetic resonance imaging and positron emission tomography revealed an enhancing mass within the temporal side of the left orbit, suggestive of choroidal metastasis from the colorectal adenocarcinoma. The condition's rarity may be due to the long and distant pathway from the colon to the orbit. The presentation usually suggests extensive hematogeneous cancer dissemination and a poor prognosis. However, palliative radiotherapy may be an effective treatment for choroidal metastasis. (Korean J Med 2015;89:723-727) Keywords: Colorectal neoplasms; Choroid; Neoplasm metastasis; Radiotherapy 서 론 결장직장암은 전 세계에서뿐만 아니라 한국에서도 세 번 째로 발생률이 높은 암으로 최근 발생률이 지속적으로 증가 하고 있다. 결장직장암은 간, 폐, 뼈, 뇌로 흔히 전이되지만 맥락막으로 전이되는 경우는 매우 드물어 전 세계적으로 14 증례가 보고된 바 있고[1,2], 한국에서는 아직 문헌상 보고된 증례는 없다. 결장직장암의 맥락막전이가 드문 이유에 대해 서는 명확하게 밝혀진 바는 없으나 전이되기 위해 거쳐야 할 경로가 길고 해부학적 장벽이 많은 것이 원인일 것으로 추 정된다[3]. 우리는 결장직장암이 맥락막으로 전이되어 증상 을 일으킨 매우 드문 경우를 경험했기에 문헌고찰과 함께 보고하는 바이다. 증 례 환 자: 51세 여자 주 소: 안구충혈 및 이물감 현병력: 내원 27개월 전에 직장구불결장 이행부에 발생한 대장암을 진단받았고, 진단 시에 병기는 TNM staging에 따
Gastric cancer frequently disseminates to the liver, lung, and bone via hematogeneous, lymphatic, or peritoneal routes. However, gastric adenocarcinoma that metastasize to the colon and that shows typical linea platisca pattern on colonofiberscopy has rarely been reported. Recently, the authors experience a case of advanced gastric cancer with colonic metastases in a 55-year-old female patient. Multiple colonic lymphoid hyperplasias were detected on colonofiberscopy and biopsy revealed metastatic gastric cancer to the colonic wall. She was treated with mFOLFOX (5-FU, oxaliplatin, leucovorin) and has achieved stable disease status without disease progression. Herein, we report a rare case of signet ring-cell gastric cancer which metastasized to the colon in the form of multiple colonic lymphoid hyperplasias.
A 58 year-old woman was diagnosed with lung adenocarcinoma (cT3N1M0). We detected a point mutation in epidermal growth factor receptor (EGFR) exon 21 (L858R) and an echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (ALK) rearrangement. The patient was treated with preoperative neoadjuvant chemotherapy and underwent a left lower lobectomy with mediastinal lymph node dissection. However, we could not detect any mutation in EGFR or the ALK rearrangement from the tumor tissue removed. Then, 70 days after completion of adjuvant chemotherapy, she visited our outpatient clinic with diminished visual accuracy and tinnitus. A single brain metastatic lesion was seen on brain magnetic resonance imaging. She underwent surgical removal of the brain mass, which showed a mutation of EGFR, exon 21, but no ALK rearrangement. We report this unusual case of lung adenocarcinoma with a coexisting EGFR mutation and ALK rearrangement, and identify gene alterations before chemotherapy, after chemotherapy, and at recurrence.
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